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PHYSICIANS P RESCRIPTIONWOPatient was seen at office on Date ___ Patient`s Name (Mom) ___ DOB (Mom) ___/___/___ /Patient is currently pregnant EDD / Patient is postpartum Baby`s DOB ___/___/___Patient`s
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How to fill out physicians prescription breast pump

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How to fill out physicians prescription breast pump

01
Obtain a prescription pad from your physician or healthcare provider.
02
Clearly indicate the medical necessity for the breast pump on the prescription.
03
Specify the type of breast pump required (e.g., manual, electric, hospital-grade).
04
Include the quantity of pumps or supplies needed, if applicable.
05
Provide your personal information as the patient (full name, date of birth, insurance details).
06
Ensure the physician signs and dates the prescription.
07
Submit the prescription to a pharmacy or supplier that provides breast pumps.

Who needs physicians prescription breast pump?

01
Mothers who have difficulty breastfeeding and require assistance with milk expression.
02
Mothers returning to work while needing to continue breastfeeding.
03
Mothers with medical conditions that hinder breastfeeding.
04
Adoptive mothers wanting to induce lactation.
05
Mothers of premature infants or those with special needs requiring extra milk.
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A physician's prescription breast pump is a medical device prescribed by a healthcare provider that allows breastfeeding mothers to extract milk for their infant.
Typically, the individual seeking reimbursement for the breast pump, usually the mother, is required to file the physician's prescription.
To fill out a physician's prescription breast pump, provide the necessary patient information, the specific breast pump model, the prescribing physician's details, and any additional instructions as per the healthcare provider's requirements.
The purpose of a physician's prescription breast pump is to ensure that breastfeeding mothers can obtain the appropriate equipment needed to express milk, especially when facing challenges in breastfeeding directly.
Essential information on a physician's prescription breast pump includes the patient's name, the physician's name and signature, the pump model, medical necessity, and the date of issuance.
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